Why Would a Workers’ Comp Claim Be Denied?

Posted on August 20th, 2021

Accidents happen, and you may be injured at work. While this can lead to you missing time from work and facing costly medical bills, workers’ compensation can be a huge help. You expect to receive workers’ compensation for an injury or illness that occurred at work or because of your job. However, sometimes your workers’ comp claim is denied, and you might not know what to do about it.

You might be wondering what happened to cause your workers’ comp claim to be denied. There are many reasons a claim may be denied, including the following factors.

Your Injury Didn’t Occur at Work

To receive workers’ compensation, your injury has to have occurred at work or be related to work. If you were not at your regular job site and were away on an assignment when you were injured, it may count as a workers’ compensation injury depending on the circumstances. However, if you’re injured while you’re at work but on a break, this claim would likely be denied. It can sometimes be difficult to determine if an injury is eligible for workers’ comp and if it’s not.

There Were No Witnesses

Injuries don’t always occur when others are around or when surveillance cameras are nearby, but that doesn’t mean they didn’t happen. If there was no one to witness the injury who could confirm it occurred at work, a claim could be denied if there isn’t enough evidence. Reporting the injury immediately if you know that there were no witnesses can help prevent a claim from being denied.

You Didn’t Notify Your Employer on Time

Certain deadlines can affect whether or not a person will receive workers’ comp. Employees in Pennsylvania have 120 days to notify their employer about their injury and three years to file a claim. If you didn’t follow this timeline, your workers’ comp claim would be denied. This is why it’s important that anyone injured at work informs their employer of their injury as soon as possible.

It Wasn’t a Workers’ Comp Injury or Illness

Not all injuries or illnesses that may be related to a job are eligible for compensation. For example, mental illnesses brought on by your position aren’t covered by workers’ compensation. If your illness or injury related to your job isn’t a workers’ comp injury, your claim would be denied.

There Was An Issue With Your Accident or Medical Reports

Insurers will be looking for any discrepancies in your claim. If your accident report and medical report don’t match up, the claim could be denied. Make sure that you’re always telling the same story of what happened whenever you speak to someone regarding your injury. If one person receives slightly different information than someone else, this can make it hard to receive compensation.

Your Injury or Illness Was Related to a Pre-Existing Condition

Some employees may see their claim denied if they have a pre-existing condition related to their injury or illness. However, even if you had a pre-existing condition, you may still be entitled to workers’ comp if the condition worsened due to your job. While you may still be eligible to receive workers’ comp, the insurance company may try to deny it due to a pre-existing condition.

Contact a Workers’ Compensation Lawyer if Your Claim Was Denied

A denied claim doesn’t mean there’s no chance for you to receive workers’ comp. You can appeal a denied workers’ comp claim, and to have the best chance at receiving compensation, you’ll need a workers’ comp lawyer. Attorney Craig P. Kalinoski of Kalinoski Law Offices P.C. can work with you if your claim was denied or help if you haven’t submitted a claim yet to help you receive adequate compensation for your injury.

When it comes to workers’ compensation injuries, you don’t want to wait to get help. Contact us today to discuss your situation with an experienced workers’ compensation lawyer in Scranton.

Category: Personal Injury

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Craig Kalinoski
Craig Kalinoski

Craig P. Kalinoski is a respected attorney serving clients in Scranton, Pennsylvania. With a focus on Family Law, Criminal Defense, and Civil Rights, he has established himself as a top-rated legal professional. Recognized as a Rising Star and admired by peers, Craig's commitment to excellence sets him apart in the legal field.


We fight for the rights of our clients in a wide spectrum of practice areas, ranging from criminal defense to family law and personal injury.

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